=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033247499
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SOMETHING'S MOVING, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/28/2007
-----------------------------------------------------
Last Update Date | 12/19/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6902 4TH ST NW SUITE A
-----------------------------------------------------
City | LOS RANCHOS
-----------------------------------------------------
State | NM
-----------------------------------------------------
Zip | 87107-6138
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 505-345-3909
-----------------------------------------------------
Fax | 505-345-0099
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 6248
-----------------------------------------------------
City | ALBUQUERQUE
-----------------------------------------------------
State | NM
-----------------------------------------------------
Zip | 87197-6248
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 505-345-3909
-----------------------------------------------------
Fax | 505-345-0099
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VICE PRESIDENT, TREASURER
-----------------------------------------------------
Name | KRISTINE M. ROY
-----------------------------------------------------
Credential | P.T.
-----------------------------------------------------
Telephone | 505-345-3909
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 2875
-----------------------------------------------------
License Number State | NM
-----------------------------------------------------